Walsh J M, Grady D
Department of Medicine, University of California San Francisco/Mount Zion 94115, USA.
JAMA. 1995 Oct 11;274(14):1152-8.
To assess the evidence that lipid lowering prevents coronary heart disease (CHD) events in women.
English-language literature assessing the effects of cholesterol lowering with dietary and/or drug interventions as primary or secondary prevention on CHD events in women.
Coronary heart disease and total mortality were the primary outcomes assessed. Angiographic regression of coronary atherosclerosis was a secondary outcome. STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS: All nine of the identified studies that met the criteria were included. Relative risks for CHD and total mortality were calculated from available data. Summary relative risks were calculated using meta-analytic techniques.
There is no evidence from primary prevention trials that cholesterol lowering affects total mortality in healthy women, although the available data are limited. Limited evidence suggests that treatment of hypercholesterolemia in women with coronary disease may decrease CHD mortality. Future research should address the role of dietary and other nondrug treatment of hypercholesterolemia in women at high risk for CHD.
评估降低血脂预防女性冠心病(CHD)事件的证据。
评估饮食和/或药物干预降低胆固醇作为一级或二级预防对女性CHD事件影响的英文文献。
评估的主要结局为冠心病和全因死亡率。冠状动脉粥样硬化的血管造影退缩为次要结局。研究选择、数据提取和数据综合:纳入所有符合标准的9项已识别研究。根据现有数据计算冠心病和全因死亡率的相对风险。使用荟萃分析技术计算汇总相对风险。
一级预防试验中没有证据表明降低胆固醇会影响健康女性的全因死亡率,尽管现有数据有限。有限的证据表明,对冠心病女性进行高胆固醇血症治疗可能会降低冠心病死亡率。未来的研究应探讨饮食和其他非药物治疗高胆固醇血症在冠心病高危女性中的作用。